Recommendations of the GARIN group for managing non-critically ill patients with diabetes or stress hyperglycaemia and artificial nutrition

Recommendations of the GARIN group for managing non-critically ill patients with diabetes or stress hyperglycaemia and artificial nutrition

Background & aims: By means of this update, the GARIN working group aims to define its position regarding the treatment of patients with diabetes or stress hyperglycaemia and artificial nutrition. In this area there are many aspects of uncertainty, especially in non-critically ill patients. Methods: Bibliographical review, and specific questions in advance were discussed and answered at a meeting in the form of conclusions. Results: We propose a definition of stress hyperglycaemia. The indications and access routes for artificial nutrition are no different in patients with diabetes/stress hyperglycaemia than in non-diabetics. The objective must be to keep pre-prandial blood glucose levels between 100 and 140 mg/dl and post-prandial levels between 140 and 180 mg/dl. Hyperglycemia can be prevented through systematic monitoring of capillary glycaemias and adequately calculate energy-protein needs. We recommend using enteral formulas designed for patients with diabetes (high monounsaturated fat) to facilitate metabolic control. The best drug treatment for treating hyperglycaemia/diabetes in hospitalised patients is insulin and we make recommendations for adapt the theoretical insulin action to the nutrition infusion regimen. We also addressed recommendations for future investigation. Conclusions: This recommendations about artificial nutrition in patients with diabetes or stress hyperglycaemia can add value to clinical work.

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Main Authors: Olveira,G., García-Luna,P. P., Pereira,J. L., Rebollo,I., García-Almeida,J. M., Serrano,P., Irles,J. A., Muñoz-Aguilar,A., Molina,M.ª J., Tapia,M.ª J.
Format: Digital revista
Language:English
Published: Grupo Arán 2012
Online Access:http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112012000600008
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spelling oai:scielo:S0212-161120120006000082013-04-11Recommendations of the GARIN group for managing non-critically ill patients with diabetes or stress hyperglycaemia and artificial nutritionOlveira,G.García-Luna,P. P.Pereira,J. L.Rebollo,I.García-Almeida,J. M.Serrano,P.Irles,J. A.Muñoz-Aguilar,A.Molina,M.ª J.Tapia,M.ª J. Diabetes Stress hyperglycaemia Enteral nutrition Parenteral nutrition Non-critically ill patients Background & aims: By means of this update, the GARIN working group aims to define its position regarding the treatment of patients with diabetes or stress hyperglycaemia and artificial nutrition. In this area there are many aspects of uncertainty, especially in non-critically ill patients. Methods: Bibliographical review, and specific questions in advance were discussed and answered at a meeting in the form of conclusions. Results: We propose a definition of stress hyperglycaemia. The indications and access routes for artificial nutrition are no different in patients with diabetes/stress hyperglycaemia than in non-diabetics. The objective must be to keep pre-prandial blood glucose levels between 100 and 140 mg/dl and post-prandial levels between 140 and 180 mg/dl. Hyperglycemia can be prevented through systematic monitoring of capillary glycaemias and adequately calculate energy-protein needs. We recommend using enteral formulas designed for patients with diabetes (high monounsaturated fat) to facilitate metabolic control. The best drug treatment for treating hyperglycaemia/diabetes in hospitalised patients is insulin and we make recommendations for adapt the theoretical insulin action to the nutrition infusion regimen. We also addressed recommendations for future investigation. Conclusions: This recommendations about artificial nutrition in patients with diabetes or stress hyperglycaemia can add value to clinical work.Grupo AránNutrición Hospitalaria v.27 n.6 20122012-12-01journal articletext/htmlhttp://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112012000600008en
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country España
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language English
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author Olveira,G.
García-Luna,P. P.
Pereira,J. L.
Rebollo,I.
García-Almeida,J. M.
Serrano,P.
Irles,J. A.
Muñoz-Aguilar,A.
Molina,M.ª J.
Tapia,M.ª J.
spellingShingle Olveira,G.
García-Luna,P. P.
Pereira,J. L.
Rebollo,I.
García-Almeida,J. M.
Serrano,P.
Irles,J. A.
Muñoz-Aguilar,A.
Molina,M.ª J.
Tapia,M.ª J.
Recommendations of the GARIN group for managing non-critically ill patients with diabetes or stress hyperglycaemia and artificial nutrition
author_facet Olveira,G.
García-Luna,P. P.
Pereira,J. L.
Rebollo,I.
García-Almeida,J. M.
Serrano,P.
Irles,J. A.
Muñoz-Aguilar,A.
Molina,M.ª J.
Tapia,M.ª J.
author_sort Olveira,G.
title Recommendations of the GARIN group for managing non-critically ill patients with diabetes or stress hyperglycaemia and artificial nutrition
title_short Recommendations of the GARIN group for managing non-critically ill patients with diabetes or stress hyperglycaemia and artificial nutrition
title_full Recommendations of the GARIN group for managing non-critically ill patients with diabetes or stress hyperglycaemia and artificial nutrition
title_fullStr Recommendations of the GARIN group for managing non-critically ill patients with diabetes or stress hyperglycaemia and artificial nutrition
title_full_unstemmed Recommendations of the GARIN group for managing non-critically ill patients with diabetes or stress hyperglycaemia and artificial nutrition
title_sort recommendations of the garin group for managing non-critically ill patients with diabetes or stress hyperglycaemia and artificial nutrition
description Background & aims: By means of this update, the GARIN working group aims to define its position regarding the treatment of patients with diabetes or stress hyperglycaemia and artificial nutrition. In this area there are many aspects of uncertainty, especially in non-critically ill patients. Methods: Bibliographical review, and specific questions in advance were discussed and answered at a meeting in the form of conclusions. Results: We propose a definition of stress hyperglycaemia. The indications and access routes for artificial nutrition are no different in patients with diabetes/stress hyperglycaemia than in non-diabetics. The objective must be to keep pre-prandial blood glucose levels between 100 and 140 mg/dl and post-prandial levels between 140 and 180 mg/dl. Hyperglycemia can be prevented through systematic monitoring of capillary glycaemias and adequately calculate energy-protein needs. We recommend using enteral formulas designed for patients with diabetes (high monounsaturated fat) to facilitate metabolic control. The best drug treatment for treating hyperglycaemia/diabetes in hospitalised patients is insulin and we make recommendations for adapt the theoretical insulin action to the nutrition infusion regimen. We also addressed recommendations for future investigation. Conclusions: This recommendations about artificial nutrition in patients with diabetes or stress hyperglycaemia can add value to clinical work.
publisher Grupo Arán
publishDate 2012
url http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112012000600008
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